Minneapolis Integrative Medicine Center, LLC
General Practice in Wayzata, MN. Organization (NPI-2).
NPI number1447857230
StatusActive
Last updated in NPPESMay 8, 2024
Details
- NPI
- 1447857230
- Entity type
- Organization (NPI-2)
- Legal business name
- Minneapolis Integrative Medicine Center, LLC
- Organization subpart
- No
- Enumeration date
- Oct 5, 2020
- Certification date
- Jan 3, 2024
- Last updated
- May 8, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Practice location
1120 Wayzata Blvd E Ste 110Wayzata, MN 55391-1984
Phone 952-222-7670 · Fax 763-210-6809
Mailing address
1120 Wayzata Blvd E Ste 110Wayzata, MN 55391-1984
Phone 952-222-7670 · Fax 763-210-6809
Authorized official
Cassandra Wilder
Owner
9522227670
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